Abstract
We report two cases of amoebic colitis. The first case was in a 45-year-old Japanese man with chief cimplaints of diarrhea and bloody stool. The patient had no history of oversea travel. A barium enema study and colonoscopy revealed multiple areas of erosion and mucosal edema in the rectum and the sigmoid colon. In paticular, several varioliform shadows were recognized in the transverse colon on barium enema study. Each elevated lesion had small barium flecks in its center. These findings suggested amoebic colitis. A high antibody titer was revealed by serologic testing (indirect hemagglutination test) . After treatment with metronidazole the symptoms and the examination findings improved. The second case was in a 39-year-old Japanese man who complained of bloody diarrhea and weight loss. The patient had no history of oversea travel. A barium enema study revealed diffuse barium flecks with some spicule formation in the rectum. On colonoscopy, multiple aphthoid ulcers and areas of hemorrhagic erosion were observed through out the rectum. These findings suggested ulcerative colitis. However, treatment with salazosulfapyridine failed to improve the symptoms. Amoebic colitis was considered as part of the differential diagnosis. Serologic testing (indirect hemagglutination test) for amoebiasis was highly positive. Salazosulfapyridine was replaced by metronidazole, and the symptoms and the examination findings improved.
